Jillian van Turnhout (Independent) | Oireachtas source

I welcome the Minister to the House. I have a number of issues I would like to raise, particularly in the area of children's health. I apologise in advance because I will have to leave early as there is a meeting of the Committee on Health and Children at 5.30 p.m. on child protection which I need to attend.

The first issue I would like to raise is the issue of mental health. I know the Minister of State, Deputy Kathleen Lynch has responsibility for this area. However, it is the effect on the whole of the health brief that is very important. I would like to get comfort from the fact the money is secured. However, we heard this in 2011, 2012, 2013 and 2014. Money is ring-fenced for mental health but we are not seeing the delivery of the services. We have no proof of how this money is being spent. In fact, if anything, I am hearing from professionals - certainly in the children and adolescent mental health services - of it getting progressively worse to access services. I am very concerned - as the Minister knows and I know and everyone in the House knows - that the likelihood is that it is going to be during the teenage years when a mental health difficulty will first present. The majority are at that time. That first experience is critical. Yet, we are seeing children having to wait four months, nine months, a year. This has an effect on their education, their community and their social environment - all those other aspects. However, it also has a huge effect on their whole lives, every time they experience a mental health difficulty.

We particularly see it in children in adult psychiatric wards. I have yet to meet somebody who agrees they should be there. However, we have seen an increase during the past year of the number of children in adult wards. I tried myself to understand why this is happening. My understanding is that some children and adolescent units are self-selecting the issues with which they will deal. They are saying - I can give an example, but I will not name the unit - they will deal with eating disorders but that is it. When there is a child with a complex or behavioural issue, they will not deal with that child. The child is moved on and pushed around the country. Can the Minister imagine that experience, without even having a mental health difficulty? Being pushed on because the person does not quite fit into the type of issue with which they want to deal. It is unacceptable.

We need clear national co-ordination, which is not happening. It needs to be considered unacceptable for a child to be in an adult psychiatric ward. Concerns are being raised by the Royal College of Surgeons in Ireland, RCSI. There are increasing waiting lists for child and adolescent mental health services. We can see the impact of this. We have seen it in recent HIQA reports into child welfare. Social workers cannot get children to access the mental health services. Where do these children go with all these complex cases? We see it also in the recent report of Carol Coulter from the Child Care Law Reporting Project, which provides details of the mental health issues of children who are ending up in the courts. It also deals with the issue of their parents with mental health difficulties. Children are going into care because their parents cannot access services. On that report, I was interested to see that the reason for almost 40% of children going into care is either addiction or physical or mental health issues. These are issues with which the health services are dealing. We very much need to clearly link and see the impact on services.

I welcome the Minister's statement on the GP services for children under six years of age and his recommitment to that and for people over 70 years of age. I note the Minister says this is to be without fees. Reports in newspapers today that fees will be charged are erroneous and misinformed. I have clearly heard the Minister say this and I read it in his statement.

The other issues I wish to raise concerns cardiac rehabilitation services and stroke issues.